A Facial Chuna Manual Therapy for Peripheral Facial Nerve Palsy

Abstract

The purpose of this study was to investigate useful manual therapy techniques for peripheral facial nerve palsy and to propose guidelines to be applied for current manual therapy techniques. Several databases were searched to find manual therapies for facial palsy. These therapies included cervical, and temporomandibular joint chuna manual therapy, proprioceptive neuromuscular facilitation, neuromuscular re-education, facial exercise, and mime therapy. Both cervical, and temporomandibular joint chuna manual therapy release nerve compression, helping blood circulation and nerve conduction. Proprioceptive neuromuscular facilitation uses irradiation, bilateral activation, and eccentric facilitation to improve muscle power and symmetry. Neuromuscular re-education, as a retraining tool for facial movement patterns, enhances neuromuscular feedback. Facial exercise helps the patient continuously move and massage facial muscle themselves. Mime therapy aims to develop a conscious connection between the use of certain muscles and facial expressions. The use of facial chuna manual therapy for peripheral facial nerve palsy can stimulate the proprioceptive neuromuscular receptors in the face. Peripheral facial nerve palsy has 4 phases; progress phase, plateau phase, recovery phase, and sequelae phase. Each phase needs different treatments which include relaxation, assistance, resistance, origin-insertion extension, and nerve pathway expansion.

Facial Chuna Manual Therapy and Acupuncture Treatment for the Sequelae of Peripheral Facial Nerve Palsy: Two Clinical Cases

“…It has been reported that contracture decreases the number and size of muscle cells, and increases the connective tissue, and fat mass on the paralyzed side as observed microscopically [18]. Symptoms of contracture include a feeling of rigidity of the facial muscles, a narrowing of the eyelids, and a deepening of the nasolabial folds [12]. Crocodile tears syndrome (where the masticatory muscles and lacrimal glands are connected) was named after the belief that crocodiles shed tears when eating [7].…”

“…Synkinesis is one of the symptoms among the sequelae of facial palsy which causes the patient to become uncomfortable. This is a symptom in which unintended facial muscles move together when a specific facial muscle is moved [12]. The most common symptom is a combination of mouth and eye movements, such as closing the eyes when smiling or raising the corners of the mouth when blinking eyes [4].…”

“…Crocodile tears syndrome (where the masticatory muscles and lacrimal glands are connected) was named after the belief that crocodiles shed tears when eating [7]. As a sequela of facial palsy, if the muscle fibers responsible for connecting the salivary glands to the lacrimal glands by compression or if there has been nerve injury and regeneration, tears may be secreted when the salivary glands are stimulated by food [12].…”

“…In addition, side effects may include necrosis of the nose and, in rare cases, loss of vision [4]. Treatment using manipulation therapies for facial palsy include cervical Chuna manual therapy, temporomandibular joint Chuna manual therapy, proprioceptive neuromuscular facilitation method, neuromuscular re-education, facial exercise, mime therapy, and non-resistance therapy [12]. However, they do not offer an individual treatment for each symptom corresponding to the sequelae of facial palsy.…”

Effect of Facial Chuna Manual Therapy Combined with Korean Medicine Treatmeant for Bell’s Palsy

“…This is because the trigeminal nerve f ibers receive proprioceptive sensations from the facial muscles and simultaneously deliver neural information to the central nervous system [12,13]. This can lead to nerve re-education and muscle recovery, by providing effective neurofeedback for the paralyzed facial muscle movement by assisting the origin and resisting the insertion region of the facial muscle [14,15].…”